Patients and Method: A prospective study was undertaken in 230 patient
s with carcinoma of the esophagus and of the cardia with infiltration
of the distal oesophageal part from 1988 to 1993. Results: According t
o postoperative UICC-classification 3% of patients had stage 0, 43% st
age I/II and 54% stage III/IV. 162/230 were resected (resection rate 7
0,4%). 55% (89/162) of resected patients had thoracoabdominocervical,
38% (62) thoracoabdominal and 8% (11) transhiatal esophagectomy. Rate
of anastomotic breakdown was 1,9% (3/162). Clinical mortality decrease
d from 32% in 1988/89 to 11% in 1990/91 to at least 0% in 1992/93 (tot
al 13%). Conclusion: Control of the postoperative phase is of decisive
importance in decreasing mortality after esophageal resection, while
surgical-technical problems seem to be solved. Esophagectomy is possib
le even as palliative measure in the presence of low mortality.